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January-April 2020
Volume 9 | Issue 1
Page Nos. 1-53
Online since Thursday, January 2, 2020
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REVIEW ARTICLE
Oral health and nicotine replacement therapy product
p. 1
Jane Manakil, Andrew Miliankos, Megan Gray, Anut Itthagarun, Roy George
DOI
:10.4103/ejgd.ejgd_100_19
Nicotine replacement therapy (NRT) products are used extensively for assisting users in achieving cessation goals through the substitution of pure nicotine with tobacco-less products. Awareness of the adverse oral effects of nicotine replacement products is important for health practitioners. This review highlights the potential effects of NRT products on the oral tissues and management of these adverse effects. Cochrane, PubMed, and MEDLINE electronic databases were utilized in search of the relevant literature related to NRT. The review highlights various adverse effects on oral health status from NRT products, with the underlying mechanisms for these effects remaining inconclusive. There is a need for more education of health professionals in oral health promotion and maintenance in these cases. NRT products have many potential adverse effects on oral health, and it is the responsibility of dental professionals to consider these in the management of patients to optimize a beneficial clinical outcome.
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ORIGINAL ARTICLES
Influence of irrigating solutions and post luting on bond strength of fiber posts after aging
p. 7
Dayane Carvalho Ramos Salles de Oliveira, Lúcia Trazzi Prieto, Josué Junior Araujo Pierote, Cíntia Tereza Pimenta de Araújo, Erick Kamiya Coppini, Luís Alexandre Maffei Sartini Paulillo
DOI
:10.4103/ejgd.ejgd_95_19
Aim:
The study aimed to evaluate the influence of irrigating solutions on bond strength (BS) of fiber posts using different luting systems after aging.
Methods:
Bovine teeth (
N
= 96) were randomly (8 groups,
N
= 12), sectioned, endodontically treated and root canals were prepared. The 96 bovine teeth were divided into four groups according to luting systems as conventional light-cure (RelyX ARC), self-adhesive (RelyX U200 and Panavia F),dual - cure self - etch, and self - adhesive (SeT PP). Each of the four groups was further divided into two subgroups using 2% chlorhexidine (CHX) gel or 5.25% sodium hypochlorite (NaOCl) as the irrigating solution. After post cementation, the metal-ceramic crowns were positioned. After 48 h, all samples were submitted to 1,000,000 thermal cycles. After water storage, push-out test was performed. The data were analyzed using two-way ANOVA and Tukey's test (
P
= 0.05).
Results:
CHX gel BS means were statistically higher than NaOCl means when posts were cemented with the conventional or dual-cure self-etch and self-adhesive resin cements; no significant statistical differences were observed between groups CHX gel or NaOCl treatments for the dual-cure self-adhesive resin cements.
Conclusion:
The irrigation solution used on endodontic treatment before luting procedures with conventional or dual-cure self-etch and self-adhesive resin cements of glass fiber posts improved long-term BS after aging.
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Assessing dental caries and related factors in 12-year-old Nigerian school children: Report from a Southeastern State
p. 11
Ezi Abigail Akaji, Queen Uche Ikechebelu, Obehi O Osadolor
DOI
:10.4103/ejgd.ejgd_89_19
Background/Aim:
Dental caries is one of the most common diseases in the world and a common health problem among children. The aim of this study was to assess dental caries and related factors using the Decayed Missing and Filled Teeth (DMFT), Significant Caries Index (SiC), Restorative and Met Need indices in 12-year-old schoolchildren in a Southeastern State of Nigeria.
Materials and Methods:
A cross-sectional descriptive study of 360 twelve year old students selected by multistage sampling method from four schools in Enugu. Sociodemographic and behavioral data on dietary and oral health-care practices were collected using questionnaires, followed by an intraoral examination of each participant in accordance with the WHO criteria to determine their individual DMFT. Total and mean DMFT were obtained. SiC, Restorative Index (RI), and Met Need Index (MNI) were calculated. Data analysis was performed using the SPSS version 20.
P
≤ 0.05 were accepted as statistically significant.
Results:
The prevalence of caries was 54.4%. Mean SiC/DMFT ratios of private and public school participants were 2.29/0.78 and 2.83/1.59, respectively. A zero RI and 0.02 MNI values were observed for all participants. Twelve (6.9%) public schoolchildren did not brush every day, although nearly 100% of them consumed cariogenic diet regularly.
Conclusion:
Despite low DMFT, number of teeth with untreated caries mirrored by zero RI and MNI values was high. Unhealthy dietary habits, suboptimal oral hygiene practices, and possibly lack of perception of gravity of caries were key influential factors. Efforts should be geared toward bridging these gaps through effective prevention program in schools.
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The effect of chlorhexidine application on the microtensile bond strength and durability of a total-etch adhesive
p. 17
Hila Hajizadeh, Maryam Bojarpour, Alireza Borouziniat, Fatemeh Namdar
DOI
:10.4103/ejgd.ejgd_50_19
Aim:
The aim of this study was to evaluate the effect of chlorhexidine (CHX) on resin–dentin microtensile bond strength (μTBS) after 6-month aging and to compare with sodium hypochlorite.
Materials and Methods:
A total of 40 extracted human third molar teeth were mounted in the acrylic resin. Flat occlusal surfaces of dentin were exposed, and after acid etching, the samples were divided randomly into four groups as follows: (a) Control group: Single Bond adhesive resin was applied. (b) The dentin surfaces were exposed to 2% CHX, and then, Single Bond was applied. (c) Dentin surfaces were treated by 5.25% sodium hypochlorite; after rinsing and drying, Single Bond was applied. (d) At first, 5.25% sodium hypochlorite was applied for 30 s, and then, 2% CHX and Single Bond adhesive were applied. Finally, Filtek P60 composite was bonded on the dentin surface. The samples of each group were divided into two subgroups of 24 h and 6 months. μTBS tests were performed using universal testing machine. Afterward, modes of failures were investigated. The statistical analyses were carried out using ANOVA,
t
-test, and Dunnett's test.
Results:
The mean of μTBS for the 24-h and 6-month groups was 15.19 and 10.99 MPa, respectively. Bond strength of all groups except Group D decreased after 6 months, and this bond strength reduction in Group C was more than other groups. Most failure modes were in adhesive type.
Conclusions:
The use of CHX did not have better preservation of μTBS when compared to control group. Use of hypochlorite is not recommended.
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Clinical evaluation of a self-etch and an etch-and-rinse adhesive system in class V noncarious composite restorations
p. 23
Carlos Eduardo Agostini Balbinot, Raquel Pippi Antoniazzi, Juliana Tabim Parode, Luciana d'Avila Farias, Camila Zamboni, Jovito Adiel Skupien
DOI
:10.4103/ejgd.ejgd_102_19
Context:
Adhesive restorations in cervical, noncarious, and nonretentive cavities are used as a clinical model for the evaluation of adhesive systems.
Aim:
The aim of this study is to evaluate restorations made by dental students of the last year of dentistry made with a self-etching and etching-and-rinse adhesive system.
Materials and Methods:
Eighty-two noncarious cervical lesions Class V cavities were restored after randomly be allocated into two adhesive groups: self-etch (AdheSe self-etch) or an etch-and-rinse (Tetric N-Bond). Operators were two well-trained students of the last year of dental school and the restorations were evaluated using a single examiner, specialist in restorative dentistry, blinded and calibrated using the criteria according to the modified United States Public Health Service. Descriptive analysis, Chi-square test to evaluate associations, and survival analysis by the Kaplan–Meier were used for statistical analysis.
Results:
There was no statistically significant difference in the evaluation of adhesive systems in Class V restorations (
P
= 0.160). There was also no statistically difference (
P
= 0.751) in the assessment of the existence of occlusal interference on lateral movement and loss of restorations. The survival rate calculated for the total restorations was 89%. The survival rate of the restorations when used etch-and-rinse adhesive systems was 92.7% while with the self-etching of 85.4%. Nine restorations were classified as lost, and one restoration cannot be assessed due to the patient having it replaced before evaluation, and the other eight restorations were lost getting the score Charlie for retention.
Conclusions:
Class V dental restorations had a satisfactory survival rate irrespective of the adhesive system.
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Effect of casein phosphopeptide-amorphous calcium phosphate and erbium:Yttrium–Aluminium–Garnet laser on shear bond strength to demineralized dentin
p. 28
Horieh Moosavi, Atefeh Nemati-Karimooy
DOI
:10.4103/ejgd.ejgd_115_19
Objective:
The aim of this
in vitro
study was to investigate the effect of casein phosphopeptide–amorphous calcium phosphate (CPP-ACP)-containing paste (MI Paste) and erbium:yttrium–aluminum–garnet (Er:YAG) laser radiation on the shear bond strength (SBS) of an etch-and-rinse (E and R) adhesives to demineralized dentin.
Materials and Methods:
Forty-eight carries-free human dentin surfaces were prepared and demineralized using acidic solutions. Then, the samples were randomly divided into four groups (
n
= 12) receiving different surface treatments. Group A (control group): no additional treatment, Group B: 3 min application of a CPP-ACP-containing cream (MI Paste), Group C: irradiation of Er:YAG laser, and Group D: irradiation of Er:YAG laser combined with 3 min application of CPP-ACP-containing cream (MI paste). Then, a composite cylinder (Filtek™ Ultimate, 3M ESPE) bonded to the surfaces using E and R adhesives (single bond) and the SBS was measured. The SBS data were analyzed using the one-way analysis of variance test followed by Tukey
post hoc
by SPSS software.
Results:
The highest SBS to demineralized dentin was observed after the application of CPP-ACP-containing paste (MI paste) without laser radiation (17.14 ± 2.07). The second highest SBS value showed in control group (11.21 ± 1.65) in which demineralized dentin received no additional treatment. However, the application of MI paste combined with Er:YAG laser irradiation resulted in the higher SBS (8.23 ± 1.02) than laser irradiation alone (5.26 ± 1.02), even though both were lower than control group.
Conclusions:
The application of CPP-ACP-containing paste (MI paste) could increase the SBS of E and R adhesives to demineralized dentin. Furthermore, laser irradiation with and without CPP-ACP application has an adverse effect on SBS.
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Effect of two irrigation protocols and obturation techniques on the apical sealing ability of different root canal sealers: An
in vitro
study
p. 33
Mohamed Abdel Aziz Mohamed El Sayed
DOI
:10.4103/ejgd.ejgd_97_19
Aim:
The aim of this study was to compare the influence of two irrigation protocols and obturation techniques on the apical seal of three endodontic sealers.
Materials and Methods:
Crowns of 130 single-rooted teeth were cut and 10 roots were selected as controls, and the remaining roots were divided into four experimental groups (
n
= 30) according to the type of irrigation protocol and obturation technique. Each group was divided into three subgroups (
n
= 10) according to the type of root canal sealer. All root canals were prepared with size F4 Protaper Universal and irrigated with 3% sodium hypochlorite (NaOCl) + 3% hydrogen peroxide (H
2
O
2
) (Groups 1 and 3) or 3% NaOCl + 2% chlorhexidine (CHX) (Groups 2 and 4). Two gutta-percha obturation techniques were used: single-cone (Groups 1 and 2) and continuous wave (Groups 3 and 4) techniques. The following sealers were tested: MTA Fillapex (Subgroup A), AH Plus (Subgroup B), and Realseal SE (Subgroup C). The apical seal was assessed using dye penetration method, and the data were statistically analyzed.
Results:
In the first group, AH Plus showed the best apical seal (0.46 ± 0.098 mm), while RealSeal SE system showed the worst apical seal (3.47 ± 0.434 mm). In the second group, MTA Fillapex (0.58 ± 0.115 mm) and AH Plus (0.63 ± 0.109 mm) showed the best apical seal. In the third and fourth groups, all types of sealers showed similar high leakage patterns. Marked increase in the apical seal of RealSeal was observed in the third group (1.71 ± 0.453 mm).
Conclusions:
The type of irrigation protocol and obturation technique could affect the apical seal of tested sealers. When the single-cone technique was used, AH Plus with NaOCl + H
2
O
2
and MTA Fillapex with NaOCl + CHX irrigation protocols showed significantly a high apical seal. RealSeal SE showed the worst apical seal when canals were irrigated with NaOCl/H
2
O
2
and filled with the single-cone technique. All sealers showed inferior results when used with the continuous wave technique.
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Assessment of root canal morphology of mandibular incisors using cone-beam computed tomography among residents of Al-Madinah Al-Munawara Region, Saudi Arabia
p. 40
Hani M Ghabbani, Asma A Marghalani, Hala R Alabiri
DOI
:10.4103/ejgd.ejgd_141_19
Objectives:
This study investigates the root configuration and prevalence of multiple canals in mandibular incisors among a Saudi subpopulation in the Al-Madinah Al-Munawara region using cone-beam computed tomography (CBCT).
Materials and Methods:
The study included imaging data from 929 CBCT scans. All scans were obtained using a CBCT device (Carestream SM 749, Rochester, NY, USA). Each scan was analyzed in two orthogonal planes (axial and sagittal) to explore information regarding tooth identification, the number of roots, and the internal morphology of the mandibular incisors. Vertucci's classification was used to categorize the canal configuration of the mandibular incisors.
Statistical Analysis:
Data interpretation was performed using SPSS software. Chi-square and one-way analysis of variance tests were applied for data analysis (
P
< 0.05).
Results:
Five hundred and twenty-three CBCT scans were excluded according to the set criteria. A total of 1624 mandibular incisors were inspected from 406 CBCT scans. In females, 275 (64.8%) teeth showed Type I configurations, and 125 (29.4%) showed Type III configurations. In males, 563 (46.9%) teeth showed Type III configurations, and 543 (45.2%) showed Type I configurations. In terms of the number of roots, all samples showed single-rooted mandibular incisors.
Conclusion:
All participants' mandibular incisors had single roots with a high incidence of single-canal configurations. The root canal configuration of the majority of lower incisors showed bilateral symmetry.
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CASE REPORT
The art of minimal tooth reduction for veneer restorations
p. 45
Carlos Alberto Jurado, Jose Villalobos-Tinoco, Akimasa Tsujimoto, Pedro Castro, Ysidora Torrealba
DOI
:10.4103/ejgd.ejgd_173_19
Minimal tooth reduction is crucial for the long-term success of adhesive restorations. It has been proven that bonding to enamel is more predictable in obtaining better long-term success than dentin due to its higher percentage of mineral content. The diagnostic wax-up and subsequent mock-up are the first diagnostic tools available to evaluate discrepancies between current and ideal tooth proportions. The intraoral mock-up provides the patient a tactile and visual evaluation of the size, shape, and shade of the proposed final restorations, and at the same time, the clinician can evaluate the smile line, lip support, phonetics, and occlusion. During the tooth preparation, the mock-up provides a reduction guide to the clinician to achieve the minimal required reduction for the final restoration avoiding the over-reduction and dentin exposure. This clinical report shows feldspathic veneer restorations provided with conservative tooth preparation. The long-term success of the restoration requires following well-defined protocols for restorative material selection, conservative tooth preparation, total isolation with rubber dam, and bonding ceramic protocols.
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LETTER TO EDITOR
Oral mucositis: Treatment and prevention
p. 53
Marcos Roberto Tovani-Palone, Sridhar Premkumar
DOI
:10.4103/ejgd.ejgd_168_19
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